February 02, 2019

China’s corruption watchdog on Saturday said it had disciplined more than 80 officials linked to a vaccine scandal last year that inflamed public fears over the safety of domestically produced drugs.

Changchun Changsheng Biotechnology – a major Chinese manufacturer of rabies vaccines – was slapped with a US$1.3 billion fine in October after it was found to have fabricated records.

Four officials from the China Food and Drug Administration (CFDA), including former deputy director Wu Zhen, have been handed over to prosecutors, the Central Commission for Discipline Inspection said in a statement on Saturday.

State-run news agency Xinhua detailed the allegations against Wu including nepotism and taking bribes. He has also been expelled from the Communist Party, it said.

“Being ‘ruthless to the people’, Wu allegedly abused his power in drug regulation, severely jeopardising the state’s supervision over drugs,” Xinhua said, citing the corruption watchdog.

The Central Commission for Discipline Inspection also said it would “seriously deal with” more than 80 other provincial or local officials from multiple government organisations, without offering details.

These officials have already been fired or demoted, it said.

Authorities earlier said the faulty rabies vaccines did not enter the market. But the case provoked outrage from customers fed up with recurring product-safety scandals, particularly in the drug sector.

The drug company’s chairwoman and 14 employees were arrested after the scandal came to light last July, while more than a dozen national, provincial and local officials were sacked.

• Since the beginning of the epidemic, the cumulative number of cases is 769, of which 715 are confirmed and 54 are probable. In total, there were 475 deaths (421 confirmed and 54 probable) and 264 people cured.

• 177 suspected cases under investigation.

• 6 new confirmed cases, including 3 in Katwa, 1 in Mangurujipa, 1 in Mutwanga and 1 in Kyondo.

• 4 new deaths

º 3 community deaths, including 1 in Mangurujipa, 1 in Kyondo and 1 in Mutwanga

º 1 death at the CTE of Butembo

• 2 new healed people, including 1 exit from the CTE of Beni and 1 from the CTE of Katwa.

/! \ The data presented in this table is subject to further changes after thorough investigation and after redistribution of cases and deaths in their health areas.

News of the response

Vaccination

• Since the beginning of vaccination on 8 August 2018, 72,248 people have been vaccinated , including 24,435 in Beni, 17,527 in Katwa, 8,099 in Butembo, 6,008 in Mabalako, 2,686 in Kalunguta, 2,150 in Komanda, 1,981 in Goma, 1,821 in Oicha, 1,663 in Mandima, 1,157 in Karisimbi, 943 in Kayina, 877 in Vuhovi, 842 in Kyondo, 750 in Masereka, 704 in Bunia, 700 in Lubero, 599 in Mutwanga, 590 in Rutshuru, 554 in Biena, 527 in Nyankunde, 442 in Musienene, 355 in Tchomia, 232 in Mangurujipa, 204 in Alimbongo, 167 in Kirotshe, 125 in Nyiragongo, 97 in Watsa (Haut-Uélé) and 13 in Kisangani.

• The only vaccine to be used in this outbreak is the rVSV-ZEBOV vaccine, manufactured by the pharmaceutical group Merck, following approval by the Ethics Committee in its decision of 19 May 2018.

Google Maps

When you look at the table in today's Ebola update, you'll see 56 cases in Butembo and 178 in Katwa: 234 cases between them, and somewhat more than Beni's 225. Katwa on the map looks like a suburb of Butembo, and it's not a long drive; they seem to amount to a single hotspot. But why would Katwa, a relatively small town, have three times as many cases as Butembo, which in 2013 had a population of 670,000?

According to a 2015 report by the World Health Organization, health care workers can have an infection rate up to 32 times higher than the general population in certain parts of the world. Infected health care workers can unknowingly spread the disease, and once sick, are unable to care for patients.

In addition to a human toll, Ebola also exacts an economic one. Treatment of an Ebola patient in the U.S. can range from $30,000-$50,000 per day, limiting the number of hospitals who can treat it, and making its spread a very costly problem.

The best hope for controlling this lethal foe is to prevent it. Researchers at the Medical University of South Carolina (MUSC) have created an online software package via the SmartState spin-off company, SimTunes, LLC, to train health care workers using simulation in safe Ebola disease response. They report promising findings in a small cohort of MUSC health care workers in an article published in the December 2018 issue of Health Security.

"This training program takes information from multiple resources, including the CDC, the National Ebola Training and Education Center and the European Network for Infectious Diseases," says Lacey MenkinSmith, M.D., assistant professor of Emergency Medicine at MUSC and first author of this article.

"What makes the program unique is that it combines all that information into one training program that is widely distributable."

"The entire course, including background material and hands-on simulation practice, is delivered over the Internet, so people can be trained immediately," adds Jerry G. Reves, M.D., distinguished professor and emeritus dean of the College of Medicine at MUSC and principal investigator of the CDC-funded study.

The software package includes a self-study component, a "hands-on" simulation workshop and a data-driven performance assessment toolset. A post-test evaluates trainees' knowledge of Ebola treatment, and software tracks and scores individual and team performance in Ebola treatment scenarios.

This training package aims to reduce the number of critical errors and risky actions committed when treating an Ebola patient. Critical errors put an individual at risk of infection or contaminate the clean zone. Risky actions increase the chance of committing a critical error.

A measles outbreak which has spread from south-west Washington to other parts of the Pacific north-west has highlighted low vaccination rates in the region, and the danger the disease presents to unvaccinated children.

The development has sparked concerns that parents deliberately choosing not to vaccinate their children – out of scientifically unfounded concerns that vaccinations can harm them – are leading to epidemics that could easily be avoided.

Washington governor Jay Inslee recently declared a state of emergency in response to a growing number of measles cases in the city of Vancouver, which lies within Clark county in the south of the state.

By 29 January, Clark county public health (CCPH) had identified 36 confirmed cases of measles and 12 suspected cases. Twenty-five cases involved children under 10, 32 of those affected had not been immunized, and the remaining four had an unconfirmed vaccination status.

CCPH also listed a range of exposure sites including schools, health centers and restaurants. Prominent among the sites were a number of Vancouver-area evangelical churches and Christian academies.

Across the Columbia River in Portland, Oregon, one confirmed case had been identified by 29 January. Exposure sites there included a church; the Moda Center, where the Portland Trailblazers play NBA games; and the Oregon Museum of Science and Industry, an attraction which is popular with the city’s children. Another case has been confirmed in King county, which contains Seattle.

Clark county vaccination rates among children are low, and far below what they were in previous decades. Between the 2004-2005 school year and 2017-2018, vaccination rates among Clark county kindergartners fell from 91.4% to 76.5%.

State laws in Oregon and Washington require students who attend schools, or engage with other institutions beyond their home to be vaccinated against a range of diseases. But, unlike in other states, where parents can ask for exemptions on medical grounds, in Oregon and Washington parents can ask for exemptions on religious or philosophical grounds relatively easily.

They do so in significant numbers. According to the CDC, in Oregon 7.5% of kindergartners had non-medical exemptions from vaccinations in 2018. In Washington, it was 3.9%.

Despite all the cheer and optimism officials are expressing (see the post just below), the Ebola DRC KIVU 2018 Dashboard shows a trend I don't like. Week 4 has recorded 48 cases, up from 40 in week 3, 23 in week 2, and 27 in week 1.

The relatively low numbers in previous weeks may be an artifact of interrupted contact tracing due to civil unrest, but if so WHO or the MoH should explain it.

Speaking of contact tracing, the dashboard also reports a gap: out of 7,600 contacts, 700 have not been traced.

Six months into the Ebola outbreak in the Democratic Republic of the Congo, efforts to stop the spread of the virus are "encouraging," Dr. Matshidiso Moeti, Director of the Regional Office, said in Geneva today. Africa of the World Health Organization (WHO).

"What worked well was public health measures such as training of infection prevention and control agents in health centers," the Africa Regional Office Director for the World Health Organization told reporters.

Dr. Moeti also emphasized closer engagement with communities, especially women and religious groups, as well as other health measures such as contact tracing alongside the use of newer tools in the past. the fight against Ebola.

Faced with the press, Dr. Moeti emphasized her optimism.

She said she was optimistic about the evolution of the disease and the change observed on the ground "with the help of local community leaders".

What she sees as a "strategy of success" has led to a situation "almost under control in Beni and Mangina, Komanda and Oicha" six months after the beginning of the epidemic.

In these first two epicentres of the health crisis, the combination of different actions contributed to a situation.

"We have learned lessons from the epidemic in West Africa, including the importance of engaging with local communities to avoid distrust and suspicion," she added.

Civil society in North Kivu on Friday (February 1st) called on the population of the Katwa Health Zone in Butembo town, which has been seen in recent days as the focus of the Ebola virus disease, to collaborate with teams fighting the epidemic. For Edgard Mateso, first vice-president of this structure, the refusal by the population to collaborate with these teams can lead to unmanageable consequences.

"To the population of the eastern part of Butembo which corresponds to the health zone of Katwa including Bulengera commune and Mususa, I ask them to understand that the Ebola virus epidemic does indeed exist in this city. We must be careful and collaborate with the teams of the response or the consequences we will not be able to manage them, " advises Edgard Mateso.

He also recommends that people keep calm.

"If today we see an explosion of positive cases in the eastern part of the city, these are cases that would probably be contaminated when there was a temporary cessation of the activities of the teams of the response to the uprising of the population when CENI made the decision to postpone the elections in this part of the country. At the time, the situation was starting to become more and more manageable," Mateso said.

February 01, 2019

Abuja, 1 February 2019 - The World Health Organization (WHO) is scaling up response to the Lassa fever outbreaks in states across Nigeria to strengthen rapid containment of the disease. WHO is mobilizing experts to intervene in investigations, contact-tracing, risk communication and plans are underway to strengthen efforts to further assist Nigeria in controlling the Lassa fever outbreak.

On 21 January 2019, the Nigeria Centre for Disease Control (NCDC) declared an outbreak of Lassa fever following an increase in the number of cases.

From 01 to 27 January 2019, a total of 213 confirmed cases including 41 deaths were reported from sixteen states (Edo, Ondo, Ebonyi, Bauchi, Plateau, Taraba, Gombe, Anambra, Kaduna, Kwara, FCT, Benue, Rivers, Nassarawa and Kogi States) across 40 Local Government Areas(LGA). This represents a significant increase in the number of cases reported compared to at the same period in 2018.

With the outbreak confirmed, WHO intensified its technical assistance to State and Federal authorities in investigation and response to the outbreak. Dr Peter Clement, the WHO Officer in Charge (OIC) for Nigeria stated that “WHO reorganized its staff to provide assistance to each of the response pillars and directed field offices to assist in outbreak investigation, coordination and response activities at the state level.

According to him, “WHO is supporting coordination, enhanced surveillance, contact tracing, and risk communication. We are also mobilizing experts to support case management and detailed epidemiological analysis to monitor situation in the affected states.”

Through the polio infrastructure in the State field offices, WHO is also providing technical assistance and coordination of partners in the affected states.

In Edo State, one of the worst hit states, the Commissioner for Health, Dr David Osifo stated “WHO continues to strengthen capacity of health workers, conduct disease surveillance as well as other control measures which include coordination of contact tracing on behalf of SMOH and engagement with communities”.

Since the onset of the outbreak, WHO in collaboration with Ministries of Health in the affected States has assisted all components of the response.

• In the reporting week 04, one new healthcare worker was affected in Enugu State- contact of an Adamawa confirmed case. A total four health care workers have been affected since the onset of the outbreak in two States – Ondo (2), Ebonyi (1) and Enugu(1) with no death.

• A total of 2070 contacts have been identified from eight states. Of these 1673(80.8%) are currently being followed up, 361(17.4%) have completed 21 days follow up. 23(1.1%) symptomatic contacts have been identified, of which 13 (0.6%) have tested positive from three states (Edo -2, Ebonyi-5 and Plateau-6).